Sterilisation (male and female)

Sterilisation works by stopping the egg and the sperm meeting.

In female sterilisation (tubal occlusion) this is done by cutting, sealing or blocking the fallopian tubes (which carry an egg from the ovary to the uterus – womb).

In male sterilisation this is done by cutting and sealing or tying the vas deferens (the tube that carries sperm from the testicles to the penis). This is called vasectomy.

Sterilisation is a permanent method of contraception, suitable for people who are sure they never want children or do not want more children. You may want to find out about long-acting reversible contraception (LARC) which is as effective as sterilisation but reversible. Ask your doctor or nurse for further information or read more about LARC here.

Your Guide to Male and Female Sterilisation (PDF)

Male sterilisation (vasectomy) – About one in 2,000 male sterilisations fail.

Female sterilisation (tubal occlusion) – The overall failure rate is about one in 200. Research suggests that when the sterilisation is done using a type of clip known as the Filshie clip, the failure rate in the 10 years after the operation may be lower (one in 333–500).
 

There is a risk that sterilisation will not work. The tubes that carry the sperm in men and the eggs in women can rejoin after sterilisation. This can happen immediately or some years after the operation has been carried out.

  • After sterilisation has worked you don't have to use contraception ever again.
  • The tubes may rejoin and you will be fertile again. This is not common.
  • Sterilisation cannot be easily reversed.
  • Sterilisation does not protect you against sexually transmitted infections.
  • It takes between four weeks and at least three months for sterilisation to be effective.

Sterilisation is for people who are sure they do not want more children or any children. You should not decide to be sterilised if you or your partner are not completely sure or if you are under any stress, for example after a birth, miscarriage, abortion or family or relationship crisis.

Research shows that more women and men regret sterilisation if they were sterilised when they were under 30, had no children or were not in a relationship. Because of this, young or single people may receive extra counselling.

You can go to your general practice or to a contraception clinic or sexual health clinic. If you prefer not to go to your own general practice, or they don't provide contraceptive services, they can refer you to another practice or clinic. All treatment is confidential and free.

In some areas, NHS waiting lists for sterilisation can be quite long. You can pay to have a sterilisation done privately.

You should get full information and counselling if you want to be sterilised. This gives you a chance to talk about the operation in detail and any concerns you may have. You should be told about:

  • other highly effective long-acting reversible contraception (LARC)
  • sterilisation failure rates, any possible complications and reversal difficulties.

You will have to sign a consent form.

By law you do not need your partner's permission but some doctors prefer both partners to agree to a sterilisation after information and counselling.

Sterilisation is meant to be permanent. There are reversal operations but they are not always successful. Success will depend upon how and when you were sterilised. Reversal is rarely available on the NHS and can be difficult and expensive to obtain privately.

Sterilisation does not affect your hormones. Therefore, your sex drive and enjoyment of sex should not be affected. For many men and women it is improved as they no longer fear an unplanned pregnancy.

You will be given a local anaesthetic. To reach the tubes, the doctor will make either a small cut or puncture, known as the no-scalpel method, in the skin of your scrotum. The doctor will then cut the tubes and close the ends by tying them or sealing them with heat. Sometimes a small piece of the tubes is removed when they are cut.

The opening(s) in your scrotum will be very small and you may not need to have any stitches afterwards. If you do, dissolvable stitches or surgical tape will be used.

The operation takes about 10–15 minutes and may be done in a clinic, hospital outpatient department or some general practice settings. Sometimes it is necessary to do the operation using a general anaesthetic, but this is not common.

Your scrotum may become bruised, swollen and painful. Wearing tight-fitting underpants, to support your scrotum, day and night for a week may help. You should avoid strenuous exercise for at least four weeks.

For most men pain is quite mild and they do not need any further help. The doctor or nurse should give you information about how to look after yourself.

Research shows that there are no known serious long-term health risks caused by having a vasectomy.

Occasionally, some men have bleeding, a large swelling or an infection. In this case, see your doctor as soon as possible. Sometimes sperm may leak out of the tube and collect in the surrounding tissue. This may cause inflammation and pain immediately, or a few weeks or months later. If this happens, it can be treated.

A small number of men experience ongoing pain in their testicles. This is known as chronic pain. Treatment for this is often unsuccessful.

The large majority of men having a vasectomy will have a local anaesthetic, but sometimes a general anaesthetic is used. All operations using a general anaesthetic carry some risks, but serious problems are rare.

About 12 weeks after the operation, you should have a semen test to see if the sperm have gone. Sometimes more than one test is needed. You can have sex as soon as it is comfortable, but you can only rely on male sterilisation for contraception after you have been told that the semen test is negative.

Following the operation, you need to use alternative contraception until the sperm left in the tubes have cleared. The time it takes for the sperm to clear the tubes varies from man to man.

There are several ways of blocking the fallopian tubes: tying, cutting and removing a small piece of the tube, sealing, or applying clips or rings. There are two main ways of reaching the fallopian tubes – laparoscopy or mini-laparotomy.

You will be given a general or local anaesthetic. A doctor will make one tiny cut and insert a laparoscope, which lets the doctor clearly see your reproductive organs. The doctor will seal or block your fallopian tubes, usually with clips or occasionally with rings.

For a mini-laparotomy you will usually have a general anaesthetic and spend a couple of days in hospital. The doctor will make a small cut in your abdomen, usually just below the bikini line, to reach your fallopian tubes.

The time you stay in hospital after sterilisation depends on the anaesthetic and the method used. It can be as little as one day.

Essure is a method of sterilisation that doesn't involve any cuts – it is known as hysteroscopic sterilisation.

A tiny titanium (metal) coil is inserted into the fallopian tubes through the vagina and cervix. Body tissue grows around the coil and blocks the fallopian tube. This does not require anaesthetic and takes about 10 minutes. This method is not reversible.

Alternative contraception needs to be used after this procedure for at least three months. You will then need a test to check that the fallopian tubes are blocked.

Doctors must undergo special training to be able to insert Essure. Your GP may be able to refer you to a doctor in your area. View www.essure.co.uk.

If you have a general anaesthetic you may feel unwell and a little uncomfortable for a few days. This is not unusual, and you may have to take things easy for a week or so. You may have some slight bleeding from your vagina, and pain. If this gets worse, see your doctor. The doctor should tell you which method of sterilisation was used, if there were any complications and how to look after yourself.

Your ovaries, uterus and cervix are left in place so you will still ovulate (release an egg each month), but it is absorbed naturally by your body.

Your periods will continue to be as regular as they were before sterilisation. Occasionally, some women find that their periods become heavier. This is usually because they have stopped using hormonal contraception, which may have lightened their periods previously.

If female sterilisation fails, and you do become pregnant, there is a small increased risk of ectopic pregnancy. An ectopic pregnancy develops outside your uterus, usually in the fallopian tube. You should seek advice straight away if you think you might be pregnant or have a light or delayed period, unusual vaginal bleeding, or if you have sudden or unusual pain in your lower abdomen.

All operations carry some risk, but the risk of serious complications is low.

You will need to use contraception until your operation and for four weeks afterwards. After hysteroscopic sterilisation you will need to use contraception for at least three months.

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This website can only give you general information about contraception. The information is based on evidence-guided research from the World Health Organization and The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists. All methods of contraception come with a Patient Information Leaflet which provides detailed information about the method.

Remember – contact your doctor, practice nurse or a contraception clinic if you are worried or unsure about anything.

INFORMATION LAST UPDATED JULY 2014. NEXT UPDATE DUE 2015.